Company Overview:

Pediatric Group Associates specializes in the comprehensive medical care of children from birth to college. Pediatric Group Associates is a division of CareCloud Practice Management a subsidiary of CareCloud Inc.

Job Summary:

The general responsibility for providing daily medical billing, collection, and customer service efforts on patient accounts, including charges and payments into the computer system ensuring resolution of reports from the billing system, claims intermediary and third-party payors.

Essential Duties and Responsibilities

BILLING:

• Receive and verify documents required for billing and follow-up purposes.
• Process primary, secondary, and tertiary claims according to respective regulations and policies
• Correspond with third-party representatives, as necessary, to complete claims processing and/or resolve problem claims
• Respond to patient and third-party inquiries via telephone or written correspondence in a timely manner.
• Interface with other departments, when appropriate, to obtain information necessary to process or resolve claims
• Follow up daily on post-processing activity including, but not limited to, rejected billings, adjustments, re-billing, and unpaid claims.
• Return documents in error to appropriate individuals for proper completion
• Work cooperatively with Front Office Staff to ensure the collection and updating of patient demographic and fiscal
• Cross-training with the front office as outlined in “Patient Representative Position”.

COLLECTION:

• Coordinate with medical office staff to ensure applicable collection of co-payments and outstanding balances from patients at the time of service
• Post payments (insurance and self-pay) to patient accounts.
• Review and reconcile electronic payments
• Update file maintenance as requested (referring physician, payor, etc.)
• Make adjustments to patient accounts according to written policies and procedures
• Research and process complex charge corrections
• Prioritize work received and complete in a timely manner

CUSTOMER SERVICE:

• Perform billing clerical duties, including review and verification of patient account information against insurance program specifications,
• Resolve routine patient billing inquiries and problems follow up on balances due from insurance companies, and type invoices to insurance companies.
• Enter data electronically to process charges, payments, denials, and adjustments
• Analyze and code procedures and diagnosis using ICD-10 and CPT codes

Education and Experience:

• Knowledge of front-office procedures. Knowledge of practice cash payment policies and procedures.
• Ability to enter patient demographic information in a computer in a timely and efficient manner.
• Greet patients and answer the telephone in a courteous and helpful manner.
• Excellent verbal and written communication skills.
• Ability to sort and file materials correctly by alphabetic or numeric systems.
• Ability to establish and maintain effective working relationships with patients, co-workers, and vendors.
• Ability to multitask.
• High school diploma or GED.
• Prefer one-year work experience, preferably in a medical office setting.
• Knowledge of medical terminology is desirable.
• Word processing and computer experience are required.

Equipment Used:

Computer, telephone, fax machine, photocopier, and other standard office equipment.

Interaction:

Work is performed in the reception area. Involves frequent contact with patients. Interaction with others is constant and interruptive. Contact involves dealing with sick children, exposure to communicable diseases, toxic substances, and medicinal preparations. May require individuals to work in outside elements to complete necessary job duties and responsibilities.

Physical Requirements:

Work may require frequent mobility and/or sitting for long periods of time; also stooping, bending, and stretching for files and supplies. Occasionally lifting files or papers weighing up to 20 pounds. Other responsibilities as assigned by the Practice Manager.

Supervisory Responsibility: No

Work Location: Moline, IL

Travel Required: N/A

Position Type: Full-Time / Non-Exempt

EEO Statement: CareCloud is an equal employment opportunity employer

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. This position requires the ability to occasionally lift office products, equipment, and supplies, up to 20 pounds.

ADA Statement: Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.

Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that

Benefits:

CareCloud recognizes the importance of benefits and wellness for employees and their families. In addition to time off to support work-life balance and enjoyment, we offer a comprehensive benefits package designed for employees’ individual needs (including domestic partners).

• Healthcare – A choice of medical plans designed to meet your individual needs
• Dental & vision
• 401(K) with company match
• Flexible spending accounts (health & dependent care)
• Company-paid life insurance (accidental and supplemental coverage at low cost)
• Company-paid Short and Long term disability
• Voluntary benefits
• Flexible PTO and Paid Holidays